The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Chinese GRADE Center, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.
Pharmacol Res. 2020 Oct;160:105101. doi: 10.1016/j.phrs.2020.105101. Epub 2020 Jul 31.
Influenza is a major public health problem worldwide. Mutations and resistance development make the use of antiviral therapy challenging. Chinese patent medicines are often used to treat influenza in China and well tolerable. However, the misuse of Chinese patent medicines is common. We therefore aimed to develop an evidence-based guideline on treating influenza with Chinese patent medicines in adults to guide clinical practice. We formed a steering committee, a consensus panel, a consultants' group and an evidence synthesis team to guide the development of the guideline. We formulated the clinical questions through two rounds of survey, and finally selected five questions. We then systematically searched the related evidence and conducted meta-analyses, evidence summaries and GRADE decision tables to draft the recommendations, which the consensus panel then voted on using the Delphi method. Finally, we formulated six recommendations based on the evidence synthesis and experts' consensus. For treating mild influenza, we suggest either Lianhua Qingwen capsule, Jinhua Qinggan granule, Banlangen granule, Shufeng Jiedu capsule, or Jinfang Baidu pill, depending on the manifestations. For severe influenza, or mild influenza in patients at high risk of developing severe influenza, we suggest Lianhua Qingwen capsule in combination with antiviral medications and supportive therapy. The strength of all recommendations was weak. Traditional Chinese medicine has great potential to help in the fight against influenza worldwide, but more high-quality studies are still needed to strengthen the evidence.
流感是全球主要的公共卫生问题。突变和耐药性的发展使得抗病毒治疗具有挑战性。中药在中国常被用于治疗流感，且耐受性良好。然而，中药的滥用较为常见。因此，我们旨在制定一个基于证据的成人用中药治疗流感的指南，以指导临床实践。我们成立了指导委员会、共识小组、顾问组和证据综合小组，以指导指南的制定。我们通过两轮调查制定了临床问题，最终选择了五个问题。然后，我们系统地搜索了相关证据，并进行了荟萃分析、证据总结和 GRADE 决策表制定建议，共识小组随后使用 Delphi 方法对建议进行投票。最后，我们根据证据综合和专家共识制定了六条建议。对于轻度流感，我们建议根据临床表现选择连花清瘟胶囊、金花清感颗粒、板蓝根颗粒、疏风解毒胶囊或金方百毒丸。对于重症流感或有发生重症流感高危风险的轻度流感患者，我们建议在联合抗病毒药物和支持治疗的基础上联花清瘟胶囊。所有建议的证据强度均较弱。中药在全球对抗流感方面具有巨大潜力，但仍需要更多高质量的研究来加强证据。
